Obesity influences the outcomes of anti‐IgE (omalizumab) therapy of asthma

Gu, Chao; Upchurch, Katherine; Mamaril-Davis, James; Wiest, Matthew; Lanier, Bob; Millard, Mark; Turner, Jacob; Joo, Hye Mee; Oh, Sang Kon

doi:10.1111/cea.13696

Cited by 19 publications

(21 citation statements)

References 11 publications

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“…Obese patients with asthma have an increased risk of severe disease, which may arise from many factors, such as changes in airway anatomy, adipokines, glucose-insulin metabolism, oxidative stress, inflammation, and genetic and epigenetic variants ( 20 ). Furthermore, similar to our finding that the SAA patients with normal weight were more likely to be responders with a reduction in exacerbations, previous reports have shown that obesity may reduce ICS response and negatively influence the beneficial effect of omalizumab in terms of asthma control in patients with asthma ( 1 , 21 ). These findings show that obesity has a great impact on the severity and prognosis of asthma, and that obesity is a particular phenotype of asthma.…”

Section: Discussionsupporting

confidence: 90%

Predictors of a Minimal Clinically Important Difference Following Omalizumab Treatment in Adult Patients With Severe Allergic Asthma

Huang

Chan

et al. 2022

Front. Med.

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Several factors have been found to be predictors of a good response following omalizumab treatment in patients with severe allergic asthma (SAA). However, it remains unclear whether clinical characteristics can predict a minimal clinically important difference (MCID) following omalizumab treatment in this population. Therefore, the aim of this study was to investigate the features associated with an MCID following omalizumab treatment in adult patients with SAA. Of the 124 participants enrolled in this retrospective, cross-sectional study, 94, 103, 20 and 53 achieved the MCID following treatment with omalizumab and were considered to be responders of exacerbation reduction (no exacerbation during the 1-year follow-up period or ≧50% reduction in exacerbations from baseline), oral corticosteroid (OCS) sparing (no use of OCS to control asthma during the study period or a reduction of the monthly OCS maintenance dose to <50% of baseline), lung function (an increase of ≧230 ml in the forced expiratory volume in 1 s from baseline) and asthma control (an increase of ≧3 points in the asthma control test score from baseline), respectively. Normal weight [<25 vs. ≧30 kg/m2, odds ratio (OR) = 3.86, p = 0.024] was predictive of a responder of reduction in exacerbations following omalizumab treatment while subjects with a blood eosinophil level of <300 cells/μL (<300 vs. ≧300 cells/μL, OR = 5.81, p = 0.001) were more likely to exhibit an MCID in OCS sparing. No factor was found to be a predictor of lung function or asthma control. When choosing treatment for adult patients with SAA, our findings may help to select those who may benefit the most from omalizumab treatment.

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Section: Discussionsupporting

confidence: 90%

Predictors of a Minimal Clinically Important Difference Following Omalizumab Treatment in Adult Patients With Severe Allergic Asthma

Huang

Chan

et al. 2022

Front. Med.

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“…In particular, Gu et al, found an inverse correlation between BMI and ACT score. On the contrary IgE levels directly correlate with BMI (30). In our cohort the same behaviour of these parameters were reported, suggesting an intriguing role of BMI on omalizumab e cacy.…”

Section: Discussionsupporting

confidence: 85%

Follicular T helper and Breg cell balance in severe allergic asthma before and after omalizumab therapy

Bergantini

d’Alessandro

Cameli

et al. 2021

Preprint

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Background Severe allergic asthma (SAA) is based on type 2 (T2-high) immune responses to allergens promoting type 2 T helper (Th2) cell cytokine responses and production of IgE antibodies. Omalizumab was the first biological drug licensed for clinical use in the management of IgE-mediated SAA. Despite, emerging evidence supporting the prominent role of follicular T cells (Tfh), Breg and Treg subsets, in the development and progression of SAA, no data is available on the impact omalizumab therapy. Methods Ten SAA patients monitored at the Respiratory Diseases Unit of Siena University Hospital and 10 healthy sex- and age-matched controls were enrolled in the study. Clinical and functional parameters were collected at baseline (T0) and after 6 months of therapy (T6). Cellular population analysis were determined through multi-color flow cytometry. Results SAA patients showed higher percentages of Th17.1, Tfh and Tfh2 while CD24 hi CD27 hi Breg cell, Treg and Tfr percentages were significantly lower than controls. Higher percentages of Tfh2 in patients with nasal polyps than in those without and in controls were observed. At T6, significant decreases of Tfh and Tfh2 than T0 were observed. A slightly significant increase in Teff was reported at T6 with respect to T0. ΔIgE levels in serum were correlated with ΔCD19 + CD24 + CD27 + Breg cell percentages (r=-0.86, p=0.0022). Conclusions Our data explored the changes of Tfh cells, Tregs and Bregs in severe asthma. The restoration of immunological imbalance in SAA patients after omalizumab is surely intriguing and represents a glimpse of light in the comprehension of immunological effects of treatment.

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“…In particular, Gu et al found an inverse correlation between BMI and ACT score. On the other hand, IgE levels directly correlate with BMI [27]. In our cohort the same findings With regard to Tfr cells, no study has yet addressed the question of involvement of Tfr cells in asthma patients [36].…”

Section: Discussionsupporting

confidence: 84%

Follicular T helper and Breg cell balance in severe allergic asthma before and after omalizumab therapy

Bergantini

d’Alessandro

Cameli

et al. 2021

Allergy and Immunology

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Background Severe allergic asthma (SAA) is based on type 2 (T2-high) immune responses to allergens promoting type 2 T helper (Th2) cell cytokine responses and production of IgE antibodies. Omalizumab was the first biological drug licensed for clinical use in the management of IgE-mediated SAA. Despite emerging evidence supporting the prominent role of follicular T cells (Tfh), Breg and Treg subsets, in the development and progression of SAA, no data are available on the impact of omalizumab therapy. Methods Ten SAA patients monitored at the Respiratory Diseases Unit of Siena University Hospital and ten healthy sex-and age-matched controls were enrolled in the study. Clinical and functional parameters were collected at baseline (T0) and after 6 months of therapy (T6). Cellular population analysis was determined through multicolour flow cytometry. Results SAA patients showed higher percentages of Th17.1, Tfh and Tfh2 while CD24 hi CD27 hi Breg cell, Treg and Tfr percentages were significantly lower than in controls. Higher percentages of Tfh2 in patients with nasal polyps than in those without and in controls were observed. At T6, significant decreases in Tfh and Tfh2 compared with T0 were observed. A slightly significant increase in Teffs was reported at T6 compared to T0. ΔIgE levels in serum were correlated with ΔCD19 + CD24 + CD27 + Breg cell percentages (r = − 0.86, p = 0.0022). Conclusions Our data explored the changes in Tfh cells, Tregs and Bregs in severe asthma. The restoration of immunological imbalance in SAA patients after omalizumab is certainly intriguing and represents a glimpse into the comprehension of immunological effects of treatment.L. Bergantini and M. d'Alessandro contributed equally to the study.

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Obesity influences the outcomes of anti‐IgE (omalizumab) therapy of asthma

Cited by 19 publications

References 11 publications

Predictors of a Minimal Clinically Important Difference Following Omalizumab Treatment in Adult Patients With Severe Allergic Asthma

Predictors of a Minimal Clinically Important Difference Following Omalizumab Treatment in Adult Patients With Severe Allergic Asthma

Follicular T helper and Breg cell balance in severe allergic asthma before and after omalizumab therapy

Follicular T helper and Breg cell balance in severe allergic asthma before and after omalizumab therapy

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